Individual
DR. ROBERT A CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301A US ROUTE 1, SCARBOROUGH, ME 04074-9701
(156) 560-2560
Mailing address
301 US ROUTE 1 STE A, SCARBOROUGH, ME 04074-4401
(715) 650-2560
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
01104300
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD23532
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
282992
NEW YORK MEDICAL LICENSE
NY
05
—
30814900
—
WI
Enumeration date
10/10/2006
Last updated
08/05/2020
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